CESSA Protocols & Standards Subcommittee Meeting 02/20/2025

CESSA Protocols & Standards Subcommittee Meeting February 20, 2025, 2:30 - 4:00 pm

• Virtual meeting via Zoom

Meeting Minutes - Approved by Members 03/06/2025

Call to Order/Roll Call

• Meeting called to order by Cindy Barbera-Brelle at 2:31 pm (via Zoom)
• Pete Dyer motioned for approval of meeting minutes from February 6, 2025, seconded by Jim Hennessey. Motion carried.
• Members present and voted to approve minutes: Rachael Ahart, Cindy Barbera-Brelle, Blanca Campos, Jessica Gimeno, Pete Dyer, Jim Hennessey, Justin Houcek, Bobby Van Bebber, Brittany Watson
• Members present and voted to abstain from approving minutes: Christina Smith
• Members absent: Brent Reynolds, Drew Hansen
• Motion to approve minutes from February 6, 2025 passes.

State Updates:

• No updates

Total Response/PowerPhone Pilot Updates (Cindy Barbera-Brelle):

• Overview of Bi-Weekly Touch Base Meetings
  • PSAP Administrators
    • Second check-in meeting was yesterday 2/19/25.
    • Meeting was positive and was a great opportunity to discuss what's going well, and if they had issues what we can do to overcome those issues.
    • The plan will be to continue to meet weekly so PSAPs have the opportunity to learn from and hear from the experiences of others.
    • For example, one of the pre-testers that continued straight into the pilots now has 60-90 days of experience and could share how things are working.
    • In one case a PSAP brought a supervisor with them. They have a co-responder model in place, so they are concerned about transferring to 988 and the process for getting to their own co-response program. We clarified that if you have a co-responder model, you don't have to transfer to 988. You have that co-responder identified, you're going to dispatch them locally, and you'll provide that type of response depending on the situation. If they don't have a co-responder model, they will transfer to 988, and if 988 determined that MCRT is required to respond, then they can transfer to MCRT with that 60 minute or less response time.
    • We discussed 988 and an issue of Centerstone declining a transfer for a wellness check. We followed up with Centerstone to ensure that all Centerstone call-takers are aware that this is on the menu of types of calls they can expect. We want to identify and address these issues early in the process.
    • Ultimately, the medical resource doctors need to approve protocol changes. Most pilot PSAPs have had preliminary conversations, or have reached out and have plans to talk with them.
    • Question from Jim Hennessey: So, if you have a co-response model in place, there's no requirement to transfer any sort of third-party caller to 988?
      • Cindy Barbera-Brelle: Correct.
      • Jim Hennessey: Okay, I just didn't know if everyone is aware of that, and it's a good thing to put out there. I just wanted to make sure that's correct before I did.
      • Cindy Barbera-Brelle: We'll go back and look at the guidance documents and see if we have to add some clarity that if you have a local co-responder model in space or an ongoing relationship that you've had before this was in place with a mobile crisis response program, that's your first resource absolutely.
      • Dr. Mary Smith: Commenting on Jim's comment, telecommunicators still need to work through the protocols and record what the responder type, even if it's co-responder. We'd still get that information as part of the pilot. It helps us to determine why certain responses were made.
      • Cindy Barbera-Brelle: Yes, one thing we are tracking is determining that what we've deployed is meeting the legislative requirement. We will want to know how many calls were transferred to 988, how many mobile crisis response team responses were there, how many co-responder responses were there, how many law enforcement responses.
  • Centerstone 988 (Dr. Mary Smith)
    • We have also had two touch-base meetings with Centerstone to discuss issues and talk about how things are going.
  • Mobile Crisis Response Team Project Directors (Dr. Mary Smith)
    • We've had one meeting with them and then will meet again every other week.
    • They are ready to go, so we are meeting to discuss any operational/technical issues or questions on the guidance.

Priority Dispatch Pilot Updates (Cindy Barbera-Brelle)

• Pre-Test Planning with the Four Pre-Test Sites
  • We met with the four pre-test sites last week.
  • Continued mapping of Determinant Codes to IRLM:
    • As a reminder the protocols are a bit different than Total Response and APCO protocols.
    • In most cases, they have to make an update in IT Systems and CAD systems, to add in new response types.
    • Some bigger systems have a CAD manager on site; others need to get their CAD vendor on site to make these adjustments.
  • Medical Director Review
    • Some of have had preliminary conversations, some are involved in RACs, and some of them have meeting coming up in the next week or so with EMS MD.
  • Training
    • CESSA-required training will need to be completed by Priority Dispatch pre-tests and pilots by 3/31/25.
  • Reporting
    • Will have a designated report so that the pre-testers can send that report automatically each week.
• Priority Dispatch Pilot Introductory Call - (February 18, 2025)
  • Had this call with the Priority Dispatch pilot sites, including four pre-testers.
  • Objective was to try to have a PSAP in each region that is using Priority Dispatch as a part of the pilot. We are close to that and confirmed another participant today.
  • The meeting presentation included a review of the following: CESSA Legislation, Protocol Overview, Pilot Procedures, Data Collection and Reporting, Communication, and Training.
  • Aiming to kick-off pilot for Priority Dispatch on April 1, 2025.
  • Will schedule another call soon to bring in the mobile crisis response team project directors for Priority Dispatch.
  • Mobile crisis response teams are excited about this and are ready to go - they have done a lot of training and preparation and want to see the impact on their teams.
• Question from Jessica Gimeno: What is the mapping process of determinant codes for Priority Dispatch? Can you explain this?
  • Dr. Mary Smith:
    • We've been working with those PSAPs who volunteered to be part of the pre-test. We're looking at three protocols - Protocol 25 (psychiatric conditions-it may be called something slightly different), Protocol 41 (first-party crisis callers), and Protocol 121 (mental health protocol for law enforcement). There are questions behind each protocol; we can't see the questions as they are proprietary and haven't been shared to us. However, they have shared specific codes that are linked to each protocol. The codes include things that relate to the IRLM, including violence, weapons, medical issues. It's a combination of the 25 numerical codes that describe conditions and suffix codes that describe things like weapons, physical aggression, and then a determinant code, which talks about the priority for response. It takes the combination of all of these codes and relates it to the IRLM.
    • They've gone through the codes and matched a specific code with a specific level of IRLM. For example, if it's a psychiatric condition, with no violence, no weapons, no medical issues, then that could be mapped to Level 1 of IRLM. So, the users of priority Dispatch have gone through all the codes and mapped them to all four levels of IRLM. It also relates to the responder type. If it's level 1 of IRLM then it's possible to connect them to 988 or possibly MCRT.
  • Jessica Gimeno: That's very helpful, thank you.
  • Cindy Barbera-Brelle: Darren and Brandon, you're on the call, anything you want to add from your experience with the mapping?
    • Darren Wolf: Dr. Smith did a great job of explaining how the system works and how we matched the codes to the matrix.
• Question from Jim Hennessey: Some of the feedback I got from one of the pilot sites, for PowerPhone/Total Response, is that the training is good for going over mental health, but it doesn't help the TCs navigate the huge gray area for identifying a mental health call. There's a lack of training for TCs in that regard. A lot of our callers are third-party, and they might not know the mental health issues of the person, but what are the red flags that we can help identify mental health issues.
  • Cindy Barbera-Brelle: Terry Soloman is on the call and she's overseeing the training effort, and we can make a note on that. One of the things we've talked about is offering some scenario training that could address this. We are also working on a de-escalation training beyond what the two courses were offering. Dr. Soloman is working with the Illinois Law Enforcement Training Standards Board on that piece of it and that is a work in progress. She'll take that note and she may want to reach out to you to get further information.
  • Dr. Mary Smith: One way we've tried to address that is by providing examples of the unusual behavior that might be described to a telecommunicator. In Total Response, that information should be on a side screen that telecommunicators can see when receiving a call. And in our Shared Drive (Box) folder, we have additional information that describes unusual behavior. Hopefully that information is being used by PSAP administrators as part of their training and discussion with telecommunicators. We have also recently created some flow charts that will help lay out the transfers.

Dr. Mary Smith

• I do want to go back to the explanation about Total Response and making referrals to co-responders. The only clarification is that, the ones we're aware of, have memos of understanding between co-responder parties. So those are the ones we'd be looking at that would be appropriate for PSAPs to indicate "Co-Responder" response type. It does have to be some sort of formal relationship that's been developed in that coverage area.
• Question from Pete Dyer: I was under the impression that we wouldn't do co-responders until this was up and running. Can we do this as part of the pilot?
  • Dr. Mary Smith: No, we're basically talking about relationships that were in place before we started the pilots. Are you asking if you could establish an MOU within the coverage area that the PSAP serves?
  • Pete Dyer: I'm looking down the road. We do have (in my town) a robust social services network that does respond with the police. When would be the appropriate time to start getting that MOU with the Kenneth Young Center which would be our 590 provider?
  • Dr. Mary Smith: I don't think we would want to stop that. I am going to take that back to the team at the Crisis Hub. But it sounds like you have an established relationship a think we would want to take that back to the team at the crisis hub. It sounds like you have a relationship and you'd just have to formalize it.
  • Pete Dyer: Yes, they've been running with this prior to any of this happening. Their concern was the time frame, 60 minutes for a response time. In town here, most of ours social workers could be there in a timely fashion, they just aren't staffed during the nighttime hours. I just want to give them information on when they can start to be co-responder.
  • Dr. Mary Smith: So this is a social service agency and not one of the MCRTs that's funded by DMH?
  • Pete Dyer: Correct, they aren't part of the grant, it's just part of our own local social workers who are responding to behavioral health incidents within our jurisdiction.
  • Dr. Mary Smith: I'll take it back and get back to you. Sounds like a great relationship.
• Question from Jim Hennessey: What if a region/RAC says that they want to go back to a co-responder model after the fact. They don't have one pre-established they just think it's a better model for them. Would that be something that would preclude them from the transfer to 988, or is that something that needs to be established before?
  • Cindy Barbera-Brella: If any city or county wants to go forward with co-responder model, they should absolutely do that. In some cases, a county doesn't have a 590, and if a neighboring county MCRT may not be able to get there in 60 minutes. All along we've said if you have a co-responder model in place in place, continue to move in that direction, that's the best opportunity for your community and your citizens to get an immediate response. They can bring that on board at anytime. And then they will have a conversation with their PSAP to say, we have a co-responder model in place and it may just be 8am to midnight. Then they could put that in the CAD system as an available resource that could be recommended as a response, with that time frame indicated, with guidance on what to do outside of that time frame (call 988, call out to MCRT). A community should consider this if they have resources that will support it.
• Question from Jessica Gimeno: When we were talking about Total Response, something happened with Centerstone, can you describe that?
  • Cindy Barbera-Brelle: One of the PSAPs in the pilot transferred a wellbeing call to 988, which is defined to be done, and Centerstone said, we don't do checks for wellbeing. So that ended up bringing the call back to the PSAP, obviously they were still on the phone and they did their response. In the meantime, Centerstone did reach out and send someone, but there was a lot of back and forth that didn't need to happen. The Hub got involved and reached out to the Centerstone contact and got that addressed. Hope it doesn't happen again and if it does, we'll have to do something different in reaching out to them so they know that this is one of the kinds of calls you can expect to get.

APCO Update (Cindy Barbera-Brelle)

• Continued review of protocols, recommendation for modifications, and meeting with vendor to modify protocols.
• Pre-Test Planning
  • Identify Pre-Test Sites
    • We don't have as many APCO sites across the State
    • Identify calls that Could be referred to 988
    • Testing data reporting
• Pilot Planning and Preparation (March)
  • Finalization of Pilot Site Participants
  • Gathering information and assessing readiness
  • Working on reporting detail
  • Convening meetings with all pilot participants to review guidance
  • Training of pilot participants

Questions from the Committee

• Jessica Gimeno in chat: Do we know if any votes will be taken on March 6? I might not be in the office then is why I ask.
  • Cindy Barbera Brelle: No, aside from approving meeting minutes.

Next Meeting Dates:

Meetings are held virtually 2:30-4:00 PM on the first and third Thursdays of each month, unless otherwise noted:

• March 6, 2025
• March 20, 2025

Public Comment:

• None

Adjournment:

• Cindy Barbera-Brelle adjourned the meeting at 3:10pm